Mandates are Political Suicide in '08? That's why Obama's health plan is better

Why are mandates for health insurance coverage such a big issue at this point in the campaign? It's the biggest difference in health policy between the top 3 candidates.

Yet despite these differences, most experts agree that the plans are similar in their most striking elements. Both Clinton and Obama advocate creating a new federal group insurance program. Anyone happy with their current health insurance could keep it. Otherwise, they could join the national insurance pool, which, the candidates like to point out, offers the same benefits that members of Congress enjoy. Edwards has a similar national public insurance plan, but would also create regional pools of private insurance companies, increasing the number of choices available.

Seddon Savage, president of the New Hampshire Medical Society, noted that all three plans believe health care should be part of the “social contract of society.” All three emphasize cost controls and cost savings, and focus on disease prevention.

“The details of the programs have some minor and some significant differences, but what all the plans are trying to do is set a direction, set basic principles,” she said. “I suspect if any one of these candidates is elected, we'll have a commitment to addressing these issues. We'll have a national dialogue, and details may change.”

John Thyng, campaign director for the advocacy group New Hampshire for Health Care, said with the exception of the mandate, the three plans are virtually the same.

Robert Reich and others state that mandates will not ensure universal coverage, that at least 15% will still be uninsured becasue they cannot afford it.

in my view Obama’s would insure more people, not fewer, than HRC’s. That’s because Obama’s puts more money up front and contains sufficient subsidies to insure everyone who’s likely to need help – including all children and young adults up to 25 years old. Hers requires that everyone insure themselves.

Yet we know from experience with mandated auto insurance – and we’re learning from what’s happening in Massachusetts where health insurance is now being mandated – that mandates still leave out a lot of people at the lower end who can’t afford to insure themselves even when they’re required to do so.

HRC doesn’t indicate how she’d enforce her mandate, and I can’t find enough money in HRC’s plan to help all those who won’t be able to afford to buy it.

I’m also impressed by the up-front investments in information technology in O’s plan, and the reinsurance mechanism for coping with the costs of catastrophic illness. HRC is far less specific on both counts. In short: They’re both advances, but O’s is the better of the two. HRC has no grounds for alleging that O’s would leave out 15 million people.”

So all three will leave millions uninsured.

The big difference is mandates and polls are showing Clinton's and Edwards' mandates to be political suicide. The Republicans will use mandates like a club and could even defeat the Democrat with that as one of their top issues. Why give them that club?

One aspect of the healthcare debate that has divided Democratic candidates is whether individuals should be required to purchase coverage – Clinton and Edwards favor a mandate, while Obama does not. A slight majority of Democratic voters who were polled – including pluralities of Clinton and Edwards supporters – opposed such a requirement.

Opposition to the notion of an individual health insurance mandate — “should individuals be required to buy health insurance” — is greatest among the less well-educated and downscale voters that are the core of Clinton's base in New Hampshire and elsewhere.

Obama, because his plan includes no mandates but insures just as many people, does not hand the Republicans that club on a silver platter.

The problem is that mandates will mean if you are uninsured and are stopped for a traffic ticket or have an overdue library book you will be signed up and maybe penalized for not having signed up sooner. Americans are just not going to go for what John Edwards is planning here:

“I'm mandating healthcare for every man woman and child in America and that's the only way to have real universal healthcare.”

“Everytime you go into contact with the healthcare system or the govenment you will be signed up.”

During a press avail following the event Edwards reiterated his mandate:

“Basically every time they come into contact with either the healthcare system or the government, whether it's payment of taxes, school, going to the library, whatever it is they will be signed up.”

When asked by a reporter if an individual decided they didn't want healthcare Edwards quickly responded, “You don't get that choice.”

This diary has one question: Are Mandates in a Democratic Health Insurance plan handing the Republicans a club to pound us with all over the purple states? The question is not whether mandates are a good idea or even necessary. Maybe they are, maybe they are not.

The question is whether mandates are so unpopular that they would be political suicide in '08.

What we are discussing here is whether Edwards and Clinton's mandates are a political mistake and would be exploited to the hilt by the bad guys.